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34个国家的初级保健机构构成情况。

Primary care practice composition in 34 countries.

作者信息

Groenewegen Peter, Heinemann Stephanie, Greß Stefan, Schäfer Willemijn

机构信息

NIVEL - Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, The Netherlands; Utrecht University, Department of Human Geography, Utrecht, The Netherlands; Utrecht University, Department of Sociology, Utrecht, The Netherlands.

Hochschule Fulda - University of Applied Sciences, Department of Health Sciences, Leipziger Straße 123, 36037 Fulda, Germany.

出版信息

Health Policy. 2015 Dec;119(12):1576-83. doi: 10.1016/j.healthpol.2015.08.005. Epub 2015 Aug 20.

Abstract

Health care needs in the population change through ageing and increasing multimorbidity. Primary health care might accommodate to this through the composition of practices in terms of the professionals working in them. The aim of this article is to describe the composition of primary care practices in 34 countries and to analyse its relationship to practice circumstances and the organization of the primary care system. The data were collected through a survey among samples of general practitioners (n=7183) in 34 countries. In some countries, primary care is mainly provided in single-handed practices. Other countries which have larger practices with multiple professional groups. There is no overall relationship between the professional groups in the practice and practice location. Practices that are located further from other primary care practices have more different professions. Practices with a more than average share of socially disadvantaged people and/or ethnic minorities have more different professions. In countries with a stronger pro-primary care workforce development and more comprehensive primary care delivery the number of different professions is higher. In conclusion, primary care practice composition varies strongly. The organizational scale of primary care is largely country dependent, but this is only partly explained by system characteristics.

摘要

随着人口老龄化和多种疾病并发情况的增加,人群的医疗保健需求发生了变化。初级医疗保健或许可通过其执业人员的构成来适应这种变化。本文旨在描述34个国家初级医疗保健机构的人员构成,并分析其与执业环境及初级医疗保健系统组织之间的关系。数据通过对34个国家的全科医生样本(n = 7183)进行调查收集。在一些国家,初级医疗保健主要由单人执业机构提供。其他国家则有更多由多个专业群体组成的较大型执业机构。执业机构中的专业群体与执业地点之间不存在总体关联。距离其他初级医疗保健机构较远的执业机构拥有更多不同的专业人员。社会弱势群体和/或少数民族比例高于平均水平的执业机构拥有更多不同的专业人员。在初级医疗保健劳动力发展更强且初级医疗保健服务提供更全面的国家,不同专业的数量更多。总之,初级医疗保健机构的人员构成差异很大。初级医疗保健的组织规模在很大程度上取决于国家,但这只是部分地由系统特征所解释。

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